Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – December 24, 2023

Medicare Advantage Plans (also known as Medicare Part C) offer the same benefits as Medicare Parts A and B, excluding hospice care, which is exclusive to Part A. However, they may also provide additional benefits unavailable through Original Medicare, such as non-prescription medication coverage or dental care benefits. While benefits vary between providers, companies offering Medicare Advantage policies must include at least the same coverage as regular Medicare.

These plans are available from Medicare-approved private insurance companies. They are subsidized by the government, so there are certain requirements involved. Enrollees must be eligible for Medicare Parts A and B and live within the insurance provider’s service area. Most Medicare Advantage Plans don’t allow people with End-Stage Renal Disease to enroll.

There are various types of Medicare Advantage Plans. Health Maintenance Organization (HMO) plans require enrollees to receive care from providers enrolled in the insurer’s network except in emergencies. Meanwhile, Preferred Provider Organization (PPO) plans cover services from both in-network and out-of-network providers. However, enrollees may pay more for services received outside their insurer’s network. There are also specialized plans (or SNPs) available designed to meet the requirements of people with complex health needs, such as those with chronic health conditions.

The number of Rhode Island residents enrolled in Medicare Advantage Plans increased by 10.34% between 2022 and 2023. This increase in enrollments slightly exceeds the U.S. average of 9.75%. Eligibility for Medicare Advantage also increased by 2.77% in Rhode Island, compared to 2.66% nationwide. Of the Rhode Islanders eligible for Medicare Advantage enrollment, 7.37% more chose to purchase a Medicare Advantage plan in 2023 than in 2022. Nationwide, enrollment among eligible citizens increased by 6.9%. Therefore, Medicare Advantage enrollment is more prevalent in Rhode Island compared to the United States as a whole, and awareness of customizable options is growing.

This guide provides a comprehensive overview of Medicare Advantage options in Rhode Island. It outlines the benefits and coverage offered by these plans, eligibility criteria for enrollment and information on how to choose and enroll in a suitable Medicare Advantage Plan. 

The Top Medicare Advantage Plans in Rhode Island

Several types of Medicare Advantage Plans are available in Rhode Island. The following table lists the eight most popular plans, including pricing and enrollment numbers. Medicare Advantage providers typically offer multiple policies. Therefore, the enrollment numbers were combined to determine the total membership for each provider in Rhode Island. The cost ranges account for price differences between plans. All cost and enrollment numbers were accurate as of July 2023, but any senior who needs the current data should visit Medicare.gov or the Centers for Medicare and Medicaid Services to learn more.

Name

Enrollment

Medicare Star Rating

Monthly Cost Range

Plan Types

Blue Cross & Blue Shield of Rhode Island

58263

5

$0 – $264

HMO

UnitedHealthcare

29074

3

$0 – $53

PPO, HMO

Blue Cross and Blue Shield

11653

5

$132 – $132

PPO

Anthem Blue Cross and Blue Shield

3815

3.5

$0 – $0

PPO

Wellcare

1852

N/A

$0 – $14

PPO, HMO

Aetna Medicare

922

3.5

$0 – $0

HMO

Blue Cross Blue Shield of Michigan

349

N/A

$0 – $29

PPO

Humana

175

4

$0 – $9

PPO

How Medicare Advantage Plans Work in Rhode Island

Medicare Advantage Plans differ from Original Medicare because they require members to use doctors and hospitals within a specific network. The rules regarding in-network and out-of-network coverage depend on the type of plan selected. In Rhode Island, Medicare Advantage providers offer four main types of plans. More information about each type is available below.

Medicare Advantage Plan Types Graphic

What Medicare Advantage Plans Cover in Rhode Island

Original Medicare doesn’t cover routine vision care, dental care or hearing aids, and coverage for other services may also be limited. What makes Medicare Advantage so attractive to its members is that providers are allowed to offer extra benefits that aren’t included in Original Medicare. Therefore, some plans cover hearing aids, dentures, eye exams and other services. With the exception of hospice care, Medicare Advantage covers the same medically necessary services as Original Medicare, including inpatient hospital care, preventive care, health screenings and diagnostic tests. Some Medicare Advantage plans also cover gym memberships or transportation to medical appointments.



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Rhode Island

Most Rhode Island residents qualify for Medicare when they turn 65, but it’s also available to younger adults with certain disabilities. Medicare enrollment is limited to U.S. citizens and lawfully admitted immigrants. To enroll in Medicare Advantage, an applicant must also be eligible for both parts of Original Medicare and live within their selected plan’s service area.

Medicare has specific enrollment periods each year, so it’s important for applicants to time their enrollment carefully. The list below provides details about enrolling in Medicare Advantage for the first time, choosing a different Medicare Advantage Plan or switching from Medicare Advantage to Original Medicare.

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Rhode Island

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

Choose a Medicare Advantage Plan



State-Wide Medicare Advantage Resources

Executive Office of Health and Human Services (EOHHS)

Rhode Island’s Executive Office of Health and Human Services (EOHHS) serves the state’s seniors through various agencies to help seniors maintain dignity and independence with Medicare counseling, food assistance, adult day services and protective supports. It also provides assistance with long-term-care issues. The EOHHS oversees the Senior Health Insurance Program (SHIP) discussed below.

Contact Info

For information and assistance, call the EOHHS Main Phone Line at 401-462-5274. 

Senior Health Insurance Program (SHIP)

Rhode Island’s Senior Health Insurance Program (SHIP) offers seniors and their families free education and counseling to help them make informed choices regarding Medicare coverage. This service is designed to clarify costs and enable beneficiaries to get the most out of their benefits.

Contact Info

SHIP representatives at the state office can be reached by phone at 401-462-0510, and local counselors are available at locations listed below.

Office of Healthy Aging

The Office of Healthy Aging, formerly known as the Division of Elderly Affairs, collaborates with organizations all over the state to connect seniors with resources and information, including healthcare information, and advocate for the rights and comforts of the elderly. It manages a Healthy Aging Help Desk where seniors and caregivers can report elder abuse, financial exploitation and neglect via a secure web portal.

Contact Info

The OHA can be reached at 401-462-3000, TTY at 401-462-0740. You can also contact OHA by email.

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The Point

The OHA oversees the Point, a network of services and programs for older residents. There are six regional Point offices throughout Rhode Island with specialists available to connect seniors to local resources for free. These services are available to individuals aged 55 and older, adults living with a disability, or their caregivers. Case Managers provide guidance with health insurance, medical assistance, elder abuse prevention and nutrition services. These trained professionals share important information about local, state and federal programs to enhance well-being and self-sufficiency.

Contact Info

Call the Point’s Central Office at 401-462-4444 for details regarding services, or call 2-1-1. You can also reach out to your nearby regional Point office listed below.Region 1 Office: Tri-County Community Action Agency – Northern RegionServing North Providence, Johnston, North Smithfield, Smithfield, Burrillville and Gloucester Phone: 401-351-2750Region 2 Office: West Bay Community Action PartnershipServing Warwick, West Warwick and East GreenwichPhone: 401-732-4660Email: [email protected]. A web contact form is available here as well.Region 3 Office: Tri-County South Community Action Agency – Southern RegionServing Charlestown, Exeter, Hopkinton, Narragansett, New Shoreham, North Kingstown, South Kingstown, Richmond, West Greenwich, WesterlyPhone: 401-789-3016Region 4 Office: United Way of Rhode IslandServing the entire statePhone: 401-519-0360Region 5 Office: East Bay Community Action Program – Upper Bay RegionServing Barrington, Bristol, East Providence and WarrenPhone: 401-437-1000, ext. 156Region 6 Office: Child and Family Services of Newport CountyServing Newport CountyPhone: 401-849-2300

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Local Medicare Advantage Resources

Warwick Senior Services – Pilgrim Senior Center

Warwick Senior Services in Warwick provides SHIP counseling for the community’s older residents by appointment only. The staff screens interested seniors to determine eligibility for Medicare Advantage and other programs using monthly income. The center also offers a legal clinic, tax help and assistance with subsidized housing and heating expenses. It publishes a newsletter to keep local seniors up to date on activities such as workshops.

Contact Info

Call Warwick Senior Services at 401-468-4070 or 401-468-4090 for information or assistance. 

Senior Services, Inc.

Senior Services, Inc., is a nonprofit offering a broad range of services for seniors and people with disabilities in northern Rhode Island. As a partner in the state’s Point network, this organization has a Community Information Specialist who shares free information on eligibility for programs, including Medicare Advantage, throughout the state. Its radio program The Senior Scene and public-access television show The Prime of Life are popular area resources for learning about benefits, services and deadlines.

Contact Info

To schedule an appointment with the Community Information Specialist, call 401-766-3734.

West Warwick Senior and Community Center

The West Warwick Senior and Community Center offers the town’s older residents SHIP options, counseling and pharmaceutical assistance in addition to meals, financial education and social activities.   

Contact Info

Call the West Warwick Senior and Community Center at 401-822-4450 to set an appointment with a SHIP counselor.

Office of Veterans Services

The Office of Veterans Services can assist Rhode Island veterans with Medicare information. Veteran Affairs benefits include prescription drug coverage which is not affected by enrollment in a Medicare Advantage plan or Medicare Part D plan.

Contact Info

Call the state Office of Veterans Services at 401-921-2119 for eligibility information and assistance.